Real-world lifelines questionnaire (fictively taken from the patient) (id = "f201")

Raw XML

<Questionnaire xmlns="http://hl7.org/fhir">
    <status value="final"/>
    <authored value="2013-06-18T00:00:00+01:00"/>
    <!--  Fictive, only the below answers are non-fictive  -->
    <subject>
        <type value="Patient"/>
        <reference value="patient/@f201"/>
        <display value="Roel"/>
    </subject>
    <author>
        <type value="Practitioner"/>
        <reference value="practitioner/@f201"/>
    </author>
    <source>
        <type value="Practitioner"/>
        <reference value="practitioner/@f201"/>
    </source>
    <name>
        <coding>
            <system value="https://lifelines.nl"/>
            <code value="VL 1-1, 18-65_1.2.2"/>
            <display value="Lifelines Questionnaire 1 part 1"/>
        </coding>
    </name>
    <identifier>
        <use value="temp"/>
        <label value="Roel's VL 1-1, 18-65_1.2.2"/>
    </identifier>

    <question>
        <!--  Seperate answer  -->
        <text value="Do you have allergies?"/>
        <answerString value="I am allergic to house dust"/>
    </question>

    <group>
        <!--  Answers to general questions  -->
       <header value="General questions"/>       
       <question>
           <text value="What is your gender?"/>                        
            <answerString value="Male"/>
        </question>
        <question>
            <name>
                <text value="What is your date of birth?"/>
            </name>
            <answerDate value="1960-03-13"/>
        </question>
        <question>
            <name>
                <text value="What is your country of birth?"/>
            </name>
            <answerString value="The Netherlands"/>
        </question>
        <question>
            <name>
                <text value="What is your marital status?"/>
            </name>
            <answerString value="married"/>
        </question>
    </group>

    <group>
        <!--  Answers to intoxications  -->
        <header value="Intoxications"/>
        
        <question>
            <text value="Do you smoke?"/>            
            <answerString value="No"/>
        </question>
        <question>
            <text value="Do you drink alchohol?"/>
            <answerString value="No, but I used to drink"/>
        </question>
    </group>
</Questionnaire>